Gel-ultraphonophoresis for patients with scarring on the skin: results of comparative prospective intervention study

Abstract

INTRODUCTION. In modern realities of peace and military trauma there are an increasing number of scar skin defects, often accompanied by pronounced subjective sensations and tissue functional limitations. An urgent task is the scientific substantiation of effective methods of their correction. OBJECTIVE. To determine healing effects and safety of using ultraphonophoresis of enzyme gel with high transcutaneous and proteolytic activity in patients with scarring on the skin. MATERIALS AND METHODS. There was examination of 82 patients with emerging (N=21 study group, N=16 comparison group) and mature (N=25 study group, N=20 comparison group) scar skin of different localizations at the rehabilitation stage after various injuries, burns, removal of skin neoplasms. The study applied clinical and functional methods in the assessment of scar tissue, medical and sociological methods in evaluating patients’ quality of life and safety profile. RESULTS. There were improved clinical indicators and functional skin properties in the scar area, a significant regression of subjective sensations, an increased quality of life score, more pronounced in the study groups. Dynamics of clinical indicators is more expressed in group 1 and group 3. Vascularization values before and after treatment in the groups were: in group 1 and 3 before treatment - 6,4±0,93 and 5,8±0,25, after - 3,0±0,24 and 2,7±0,31, respectively; in group 2 the values before and after treatment were 5,6±0,26 и 4,2±0,62, respectively, in group 4 – before treatment 4,9±0,53, after - 4,1±0,48. As a result of dynamics of the quality of life indicators, a more significant improvement was found in the study groups with respect to the comparison groups. In the group with emerging scars the sum of points before treatment was 20,4±0,3, after treatment - 12,4±0,3; in the comparison group - 18,7±0,5 and 13,4±0,5 before and after treatment, respectively; in the group with mature scars: before treatment - 23,6±0,3, after - 13,7±0,4; in the comparison group - 21,3±0,4 и 16,2±0,5 before and after treatment, respectively. A favorable safety profile of treatment was defined: adverse events (tingling, burning) were transient and fully cupped after the procedure. DISCUSSION. Ultraphonophoresis, one of the man methods in the transdermal delivery, contributes to changing the epidermal barrier permeability for molecules of various drugs as well as potentiation for actions of anti-scarring agents at different stages of emerging and existing scar skin defects. CONCLUSION. Ultraphonophoresis of the enzyme gel with a high transcutaneous and proteolytic activity has fibromodulating and sedative curative effects in patients with scarring skin of different genesis and duration.